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SAN OA Q N COMMUNITY DEVELOPMENT DEPARTMENT <br /> COUNTY- SITE APPROVAL/USE PERMIT <br /> FILE NUMBER: <br /> SERVICES <br /> Water <br /> Service Provider: Will Serve Letter Provided <br /> Public ❑� CSA-3 ❑� Distance to <br /> Public Water: Adjacent <br /> Private <br /> ❑ Existing Well New Well Well Replacement <br /> ❑ ❑ ❑ <br /> Wastewater Disposal <br /> Public ElService Provider: Will Serve Letter Provided Distance to <br /> ❑ Public Sewer: <br /> Private ■ Existing Septic System New Septic System Septic System Replacement <br /> ❑ 0 ❑ <br /> Description of process wastewater: Volume of process Method of disposal: <br /> If the project will result in wastewater: <br /> process wastewater provide <br /> the following information: <br /> Storm Drainage <br /> Service Provider: Will Serve Letter Provided Distance to <br /> Public CSA-31_n 1 FE Public Storm <br /> Drain: <br /> ElExisting On-site Retention Pond New On-site Retention Pond Natural Drainage <br /> Private <br /> ❑ ❑ ❑ <br /> Other Public Services <br /> School Service Fire Protection Service <br /> Service Provider Distance to Service Provider Distance to <br /> N?A School: N/A Woodbridge Fire Station: 500 Yards +/- <br /> Page 3 of 6 <br /> 08113/2021 <br />